Romneycare not end of the world

Millions of Americans have been watching, waiting, for the sky to fall on the commonwealth of Massachusetts.
Two years ago the state passed a health-insurance bill that looked a bit like the federal bill Congress passed last year. Bay State Republicans predicted economic catastrophe when the bill, dubbed Romneycare, went into effect.
Chicken Little was wrong: the economic sky did not tumble. In fact, the state looks in better health, insurance-wise, than before the state Legislature acted, according to health-policy journal Health Affairs.
Consider the all-important statistic: the uninsured. In 2006, 86.6 percent of the state’s nonelderly residents were insured – higher than in many parts of the nation. By 2010, 94.2 percent were insured. The reason: Romneycare. Without it, Massachusetts would have seen its census of uninsured rise, as layoffs drove more people off their employers’ rolls (and bankruptcies eliminated some other employers’ rolls entirely). Coincidentally, emergency- room visits, as well as inpatient hospital stays, declined.
As for costs, they rose, but they’ve risen throughout the country. Romneycare, moreover, did not seek to curtail costs.
Of course, Massachusetts is not the nation. Will the Affordable Care Act, dubbed Obamacare, topple the economic sky? I think not.
As in Massachusetts, the census of the insured will rise. Citizens will still worry about jobs, the environment, foreign wars. But people who are ill, needing care, won’t be hysterical that they cannot pay.
As for the regulations that the federal law imposes on private insurers, we regulate the drugs we consume, the cars we drive and the toys we play with. Obamacare will nix some of the toxic insurance products.
Consider a few. No more exclusions for pre-existing conditions. From the vantage point of insurers, these exclusions are wonderful: they reduce the insurer’s risk from the outset. Only the patients have suffered.
Huge profits will also go into the ash heap, as regulators are given the power to roll back rate hikes that are considered unreasonable.
Policies will no longer drop young adults at age 21. Those recent college graduates searching for a job with insurance can stay on their parents’ policies until age 26.
Under the Affordable Care Act, policies will have to cover immunizations and preventive services. “Caps” and “lifetime ceilings” will also go. People who need major surgery or rehabilitation won’t hear, midway, that they have exhausted their benefits, hit their ceiling.
The sky won’t fall. Years from now, we’ll wonder why we feared it would. •


Joan Retsinas is the managing editor of Medicine & Health/Rhode Island, a monthly journal of the Rhode Island Medical Society.

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